This map shows Universal health care around the world. Universal health care is a national health insurance program in many countries that is mostly financed by taxes and administered by the government to provide comprehensive health care that is accessible to all citizens of that nation.

The health care system is heavily dependent on humanitarian aid and money sent home by emigrants, and the ongoing brain drain is depleting the country of its most valuable human resources. Yet despite the difficulties, the basic infrastructure for health care delivery is being maintained and rationalized. The success or failure of the reforms will depend on the country's continued stability and its economic recovery.

Algeria

Public universal health care through other means

American Samoa

NA

Andorra

Public universal health care through other means

1966

The Andorran health care system is based on a social insurance model. Citizens' health care rights are recognized by the constitution. Health care services are provided and financed by both private and public sectors. About 92% of the population is covered by the CASS (la Caixa Andorrana de Seguretat Social -the Andorran Office of the Social Security).

Angola

NA

Anguilla

NA

Antarctica

NA

Antigua and Barbuda

NA

Argentina

Public universal health care through other means

Health care is provided through a combination of employer and labor union-sponsored plans (Obras Sociales), government insurance plans, public hospitals and clinics and through private health insurance plans.

Armenia

No

Aruba

NA

Australia

Two Tier

1975

Australia is committed to public financing and substantial public delivery in health care. The health system offers universal access to health care, regardless of ability to pay, through the government administers the compulsory national health insurance program, Medicare, which is financed through general taxation and a health tax levy. This provides the entire population with subsidized access to the doctor of their choice for out-of-hospital care, free public hospital care and subsidized pharmaceuticals. Government provides a baseline of care, and in which a significant percentage of individuals purchase additional health insurance or premium direct health care.

Austria

Public universal health care through other means

1978

The Austrian health care system is characterized by the federalist structure of the country, the delegation of competencies to stakeholders in the social insurance system as well as by crossstakeholder structures at federal and Länder levels which possess competencies in cooperative planning, coordination and financing. There has traditionally been regulated competition between service providers for patients and contracts with the social insurance institutions, but not between the health insurance funds themselves. The sectors of the health care system have customarily been characterized by different stakeholders and regulation and financing mechanisms. However, in recent years there have been increased efforts to introduce decision-making and financing flows which are effective across all sectors.

Azerbaijan

Public universal health care through other means

1991

The current structure of the health care system was one of the least effective in the Soviet republics, and it deteriorated further after independence. As a result, the country experienced outbreaks of diseases that had once been controlled, and others, such as tuberculosis, began to increase; the health system faced near complete collapse.

Bahamas, The

NA

Bahrain

Single-payer

1957

Bangladesh

NA

Barbados

NA

Belarus

Public universal health care through other means

1991

Belarus has managed to maintain a health care delivery system that provides a comprehensive package of care to the entire population, which is generally free at the point of delivery.

Belgium

Public universal health care through other means

1945

The Belgian health system is based on the principles of equal access and freedom of choice, with a Bismarckian-type of compulsory national health insurance, which covers the whole population and has a very broad benefits package.

Belize

NA

Benin

NA

Bermuda

NA

Bhutan

Single-payer

The Royal Government of Bhutan maintains a policy of free and universal access to primary health care. As hospital facilities in the country are limited, patients with diseases that cannot be treated in Bhutan, such as cancer, are normally referred to hospitals in India for treatment. Such referral treatment is also carried out at the cost of the Royal Government.

Bolivia

NA

Bosnia and Herzegovina

Public universal health care through other means

Botswana

NA

Bouvet Island

NA

Brazil

Public universal health care through other means

The universal health care system was adopted in Brazil in 1988 after the end of the military regime's rule. However, free health care was available many years before, in some cities, once the #27 amend to the 1969 Constitution impose to the municipalties the duty of applying 6% of their income in healthcare.

British Indian Ocean Territory

NA

British Virgin Islands

NA

Brunei

Single-payer

1958

The people of Brunei Darussalam enjoy free medical and health care provided via government hospitals, health centres and health clinics.

Bulgaria

Public universal health care through other means

Burkina Faso

NA

Burma

NA

Burundi

NA

Cambodia

NA

Cameroon

NA

Canada

Single-payer

1966

In Canada, national health insurance (Medicare) is a public program administered by the provinces and overseen by the federal government. Medicare is funded by income taxes and sales tax revenues. All Canadian citizens have health care.

Cape Verde

NA

Cayman Islands

NA

Central African Republic

NA

Chad

NA

Chile

Public universal health care through other means

China

Public universal health care through other means

The New Rural Co-operative Medical Care System (NRCMCS) is a 2005 initiative to overhaul the healthcare system, particularly intended to make it more affordable for the rural poor. While health insurance coverage is increasing, especially in rural areas, many people are underinsured and continue to face high out-of-pocket costs. While the health insurance schemes, particularly in rural areas, report high coverage, benefits are often limited to catastrophic illness; inpatient medical services frequently require pre-payment and reimbursement can be as low as 20%-30% of the total bill.

Christmas Island

NA

Cocos (Keeling) Islands

NA

Colombia

NA

Comoros

NA

Congo, Democratic Republic of the

NA

Congo, Republic of the

NA

Cook Islands

NA

Costa Rica

Public universal health care through other means

Côte d'Ivoire

NA

Croatia

Public universal health care through other means

Cuba

Single-payer

1959

Cuba has a national health service. Services are available without charge to everyone. They are provided by salaried personnel in facilities run by the government.

Cyprus

Single-payer

1980

Czech Republic

Public universal health care through other means

Denmark

Public universal health care through other means

1973

Denmark has a universal public health system paid largely from taxation with local municipalities delivering health care services in the same way as other Scandinavian countries.

Djibouti

NA

Dominica

NA

Dominican Republic

NA

Ecuador

NA

Egypt

Public universal health care through other means

El Salvador

NA

Equatorial Guinea

NA

Eritrea

NA

Estonia

Public universal health care through other means

Ethiopia

NA

Falkland Islands (Islas Malvinas)

NA

Faroe Islands

NA

Fiji

NA

Finland

Single-payer

1972

In Finland,Perceived imbalances between primary and specialized health care led to the Primary Health Care Act 1972, which introduced a network of primary health care centres, publicly owned and staffed, in charge of delivering integrated preventive and curative services.

France

Public universal health care through other means

1974

The health care system is regulated by two main players: the state – the National Assembly, the government and ministries – and the statutory health insurance funds. To a lesser extent, local communities play a role in regulating the system. The Juppé reform of 1996 clarified the roles of the state and insurance funds and reinforced the role of the regions.

French Guiana

NA

French Polynesia

NA

French Southern and Antarctic Lands

NA

Gabon

NA

Gambia, The

NA

Georgia

Public universal health care through other means

Germany

Public universal health care through other means

1941

Germany uses a social insurance model. All citizens must have health insurance, which they purchase from one of more than 200 private, nonprofit sickness funds.

Ghana

Public universal health care through other means

In Ghana, most health care is provided by the government, but hospitals and clinics run by religious groups also play an important role. Some for-profit clinics exist, but they provide less than 2% of health services.

Gibraltar

NA

Greece

Public universal health care through other means

1983

Greenland

NA

Grenada

NA

Guadeloupe

NA

Guam

NA

Guatemala

NA

Guernsey

NA

Guinea

NA

Guinea-Bissau

NA

Guyana

NA

Haiti

NA

Heard Island and McDonald Islands

NA

Holy See (Vatican City)

NA

Honduras

NA

Hong Kong

Public universal health care through other means

1993

Hungary

Public universal health care through other means

Iceland

Single-payer

1990

India

Public universal health care through other means

India has a universal health care system run by the local (state or territorial), governments. The government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense. Most essential drugs are offered free of charge in these hospitals.

Indonesia

NA

Iran

Public universal health care through other means

Iraq

NA

Ireland

Public universal health care through other means

1977

Isle of Man

NA

Israel

Public universal health care through other means

1995

In Israel, the National Health Insurance Law (or National Health Insurance Act) is the legal framework which enables and facilitates basic, compulsory universal health care.

Italy

Single-payer

1978

Italy has a public health care service for all the residents called "Servizio Sanitario Nazionale" or the National Health Service (NHS). It is publicly run and funded mostly from taxation: some services requires small co-pays, while other services are completely free of charge.

Jamaica

NA

Japan

Single-payer

1938

Japan uses a "social insurance" system in which all citizens are required to have health insurance, either through their work or purchased from a nonprofit, community-based plan. Those who can't afford the premiums receive public assistance. Most health insurance is private; doctors and almost all hospitals are in the private sector.

Jersey

NA

Jordan

NA

Kazakhstan

Public universal health care through other means

Kenya

NA

Kiribati

NA

Korea, North

Public universal health care through other means

North Korea has a national medical service and health insurance system.

Korea, South

Public universal health care through other means

1988

Kuwait

Single-payer

1950

Kyrgyzstan

NA

Laos

NA

Latvia

Public universal health care through other means

Lebanon

NA

Lesotho

NA

Liberia

NA

Libya

Public universal health care through other means

Liechtenstein

Public universal health care through other means

Lithuania

Public universal health care through other means

Luxembourg

Public universal health care through other means

1973

Macau

Single-payer

Macedonia [FYROM]

NA

Madagascar

NA

Malawi

NA

Malaysia

Public universal health care through other means

Maldives

NA

Mali

NA

Malta

Public universal health care through other means

Marshall Islands

NA

Martinique

NA

Mauritania

NA

Mauritius

NA

Mayotte

NA

Mexico

Public universal health care through other means

Public health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government.

Micronesia, Federated States of

NA

Moldova

Public universal health care through other means

Monaco

Public universal health care through other means

Mongolia

Public universal health care through other means

Montenegro

NA

Montserrat

NA

Morocco

Public universal health care through other means

Mozambique

NA

Namibia

NA

Nauru

NA

Nepal

NA

Netherlands

Public universal health care through other means

1966

Netherlands Antilles

NA

New Caledonia

NA

New Zealand

Two Tier

1938

Primary health care is provided by primary health organizations, which contract with District Health Boards for the bulk of their funding. New Zealand's healthcare system is funded through general taxation.

Nicaragua

NA

Niger

NA

Nigeria

NA

Niue

NA

Norfolk Island

NA

Northern Mariana Islands

NA

Norway

Single-payer

1912

The National Insurance Act guaranteed citizens universal access to all forms of medical care. Norway's health system is funded by progressive income tax, and from block grants from central government. Patients are free to choose their own physician and hospital, however, registration with local GP's who act as gatekeeper, will begin in 2001.

Oman

NA

Pakistan

Public universal health care through other means

Palau

NA

Panama

Public universal health care through other means

Papua New Guinea

NA

Paraguay

NA

Peru

Public universal health care through other means

Philippines

NA

Pitcairn Islands

NA

Poland

Public universal health care through other means

Portugal

Single-payer

1979

Puerto Rico

NA

Qatar

Public universal health care through other means

Réunion

NA

Romania

Public universal health care through other means

Russia

Public universal health care through other means

Rwanda

NA

Saint Barthélemy

NA

Saint Helena

NA

Saint Kitts and Nevis

NA

Saint Lucia

NA

Saint Martin

NA

Saint Pierre and Miquelon

NA

Saint Vincent and the Grenadines

NA

Samoa

NA

San Marino

Public universal health care through other means

Sao Tome and Principe

NA

Saudi Arabia

Public universal health care through other means

Senegal

NA

Serbia

Public universal health care through other means

Seychelles

Public universal health care through other means

Sierra Leone

NA

Singapore

Single-payer

1993

Singapore has a universal health care system where government ensures affordability, largely through compulsory savings and price controls, while the private sector provides most care.

Slovakia

Public universal health care through other means

Slovenia

Public universal health care through other means

Solomon Islands

NA

Somalia

NA

South Africa

Public universal health care through other means

South Africa's health system consists of a large, under-resourced public sector (serving 80 percent of population) and a small private sector for high income earners (20 percent of the population). Primary health care is free to everyone but highly specialized services are available in the private sector to those who can afford it.

South Georgia and the Islands

NA

Spain

Single-payer

1986

The Spanish health care system is funded by payroll taxes through the National Institute of Health program (INSALUD)

Sri Lanka

Public universal health care through other means

Sudan

NA

Suriname

NA

Svalbard

Single-payer

Swaziland

NA

Sweden

Single-payer

1955

The Swedish health care system is financed by both incomes tax and patient fees. County councils own and operate hospitals, employ physicians and run the majority of general practices and outpatient facilities. Other physicians work in private practice and are paid by the counties on a fee-for-service basis. Tuition for medical and nursing education is free.

Switzerland

Public universal health care through other means

1994

In Switzerland, compulsory health insurance covers the costs of medical treatment and hospitalization of the insured. The Swiss healthcare system is a combination of public, subsidized private and totally private healthcare providers, where the insured person has full freedom of choice among the providers in his region. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They may not make a profit off this basic insurance, but can on supplemental plans.

Syria

Public universal health care through other means

Taiwan

Single-payer

The current health care system in Taiwan, known as National Health Insurance (NHI), was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralizes the disbursement of health care dollars. NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for both public and private providers.

Tajikistan

Public universal health care through other means

Tanzania

NA

Thailand

Public universal health care through other means

Timor-Leste

NA

Togo

NA

Tokelau

NA

Tonga

NA

Trinidad and Tobago

Public universal health care through other means

Tunisia

Public universal health care through other means

Turkey

Public universal health care through other means

Turkmenistan

Public universal health care through other means

Turks and Caicos Islands

NA

Tuvalu

NA

Uganda

NA

Ukraine

Public universal health care through other means

United Arab Emirates

Single-payer

1971

United Kingdom

Single-payer

1948

United Kingdom has a National Health Service that provides public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation.

United States

in transition

2014

2010 legislation has laid the ground for one to be fully functioning by 2014.